Transurethral microwave therapy (TUMT) for benign prostatic hyperplasia
In transurethral microwave therapy (TUMT), an instrument (called an antenna) that sends out microwave energy is inserted through the urethra to a location inside the prostate. Microwave energy is then used to heat the inside of the prostate. Cooling fluid is circulated around the microwave antenna to prevent heat from damaging the wall of the urethra. To prevent the temperature from getting too high outside the prostate, a temperature sensor is inserted into the man's rectum during the procedure. If the temperature in the rectum increases too much, the treatment is turned off automatically until the temperature goes back down.
The temperature becomes high enough inside the prostate to kill some of the tissue. As this part of the prostate heals, it shrinks, reducing the blockage of urine flow.
Microwave therapy is also known as cooled thermal therapy or by the name of the equipment (Targis or Prostatron).
What To Expect After Surgery
You are generally able to go home after surgery. You may not be able to urinate and may require catheterization to drain your bladder. For most men, this lasts for a week or less. You may also have to take antibiotics or anti-inflammatory medicines.
You can generally return to work 1 to 2 days after treatment. Sexual activity can be resumed 1 to 2 weeks after surgery.
Why It Is Done
TUMT is done to help relieve the symptoms of benign prostatic hyperplasia (BPH). It is an option for men who want more than medicines for treatment of their symptoms.
How Well It Works
Studies note that TUMT is more effective than treatment with the alpha-blocker terazosin when checked 18 months later.1
In a summary of very small studies, TUMT did not improve symptoms and urine flow as much as transurethral resection of the prostate (TURP) did. But men seemed equally happy with either surgery. And more research is needed.1
The main complication of TUMT is the inability to urinate (urinary retention) for more than a week.2 This condition is treated by inserting a tube directly through the abdominal wall into the bladder to drain urine (suprapubic catheter). Erection problems and retrograde ejaculation (ejaculation backward into the bladder) appear to be less common after TUMT than after TURP.2
Other complications include persistent irritation of the urethra and blood in the urine.1
Reports have warned that the procedure has in a small number of cases caused serious injuries and complications, including damage to the penis and urethra. Injuries have required colostomies, partial amputation of the penis, and other procedures. In December 2000, the U.S. Food and Drug Administration (FDA) issued a warning about these injuries.3
What To Think About
Most trials using TUMT have been limited by a small number of participants, a short length of time of study, and limited follow-up of the participants after the trial ended.
This procedure is not recommended for men with prostate cancer or for men who are suspected of having prostate cancer.
- Webber R (2006). Benign prostatic hyperplasia, search date May 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
- Fitzpatrick JM (2007). Minimally invasive and endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803–2844. Philadelphia: Saunders Elsevier.
- U.S. Food and Drug Administration (2002). Microwave therapy warning. JAMA, 284(21): 2711.
Last Updated: March 24, 2008